Harmony Healthcare Blog

Medicare Part B Outpatient Therapy Caps Eliminated: Top 5 Hot Points

Posted by Kris Mastrangelo, OTR/L, LNHA, MBA on Tue, Feb 13, 2018

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Edited by Kris Mastrangelo


Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency

Portrait of female instructor assisting senior woman in lifting dumbbells at gym.jpegThe Medicare Part B Caps eliminated!  This is exceptional news and all of the healthcare associations are commended on their diligent work and representation on behalf of: 

  • Beneficiaries
  • Occupational Therapists
  • Speech Therapists
  • Healthcare Providers
  • Community 

The Top 5 Hot Points: 

  1. Effective January 1, 2018
  2. KX Modifier
  3. Target Reviews
  4. HCPC Increase
  5. Therapy Assistant Reimbursement Change 

Medicare Part B Outpatient Therapy Caps
This includes Part B therapy provided in SNF’s

January 1, 2018


KX Modifier

  • SLP and PT $2,010
  • OT $2,010

No modifier, no payment


Fee Schedule increase of 0.5% effective January 1, 2019.  Reduced by 0.25%

Target Reviews

For a limited amount of claims over $3,000

Therapy Assistant
(PT and OT)

15% Decrease effective January 1, 2022


Thank you for your kind words and feedback on the blog.  See you Friday on the Free Key Friday Webinar.  We will be discussing RCS-1.

Click Here to Register for the RCS-1 Webinar

Harmony Healthcare International (HHI) is available to assist with any questions or concerns that you may have. You can contact us by clicking here.  Looking to train your staff?  Join us in person at one of our our upcoming Competency/Certification Courses.  Click here to see the dates and locations. 

Join us November 1st & 2nd, 2018 at Mohegan Sun Resort for harmony18
7th Annual LTPAC Symposium
Click Here to Register
harmony20 October 29-30 2020 Encore Boston Harbor

Tags: Medicare Part B

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